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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2003, Número 6

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Acta Ortop Mex 2003; 17 (6)


Análisis comparativo del enclavijamiento de las fracturas supracondíleas de húmero en niños

Díaz-Borjón E, Martínez DSA, Valle-de Lascurain G, Guzmán-Robles O

Idioma: Español
Referencias bibliográficas: 74
Paginas: 298-305
Archivo PDF: 84.92 Kb.


RESUMEN

Introducción: Existe controversia con respecto a la colocación de clavillos de Kirschner para la fijación de fracturas supracondíleas humerales en niños, algunos autores sugieren que deben ser colocados en forma cruzada pues ofrecen una mayor estabilidad, otros autores prefieren la colocación lateral de los mismos, debido a la probable lesión iatrogénica del nervio cubital. Objetivo: Demostrar que ambos métodos de fijación son estables, esclarecer las ventajas y desventajas de ambas técnicas. Material y método: Estudio prospectivo, longitudinal, comparativo, descriptivo, observacional. Se estudiaron un total de 50 pacientes con fracturas supracondíleas humerales tipo II y III de Gartland sometidos a intervención quirúrgica mediante enclavijamiento cruzado27 y lateral.23 Resultados: Según los criterios de Flynn, 96% de los pacientes presentaron resultados estéticos excelentes, sin existir diferencias significativas (p = 0.40); 92% de los niños tuvieron resultados funcionales excelentes o buenos, sin diferencias estadísticamente significativas (p = 0.45). Los arcos de movilidad en flexión y extensión del codo fueron igualmente muy similares. Se encontraron seis casos de lesión del nervio cubital en el grupo de niños intervenidos con clavillos cruzados. Discusión: Tanto la fijación con clavillos de Kirschner cruzados o laterales ofrece una satisfactoria estabilidad, con resultados funcionales y estéticos muy similares. Sin embargo, la presencia de lesión del nervio cubital en aquellos pacientes intervenidos con clavillos cruzados puede ser una limitante para esta técnica, sobre todo en los casos en que el edema local impide la adecuada palpación de las referencias óseas.


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